Other cardioembolic causes or embolic causes from the heart area would include a valvular disease if you have a mechanical valve. And so it's interesting. There are two types of valves that are put into the heart. One is what's called a bioprosthetic valve, which is usually from pigs, a porcine valve. Those aren't much of a risk, but metal valves that the surgeon sometimes put in can be a high risk for forming blood clots in patients who have those types of middle valves are usual and very aggressive blood thinners like coumadin or Warfarin. Other areas that can cause stroke are also atherosclerosis of the aorta, if that's very severe, that can actually break off and go into the brain. Then as we move up, we go into the neck and we look for causes of stroke in the neck. And one of the biggest causes we'd be carotid stenosis. The carotid arteries are on either side of the neck and basically you have four big pipes coming in to the neck. You have two arteries that come to the back. They're called the vertebral arteries. They supply the back, the brainstem in the back of the brain. And then you've got the carotid arteries, which supply the anterior two thirds of your brain. And what can happen very frequently with diabetes, high blood pressure, high cholesterol, age, genetic predisposition, smoking, is that the carotid artery can start to become narrowed and it's usually filled with cholesterol, plaque filled with cholesterol. And if that narrows to a point, and that's usually something above 75% that can then become unstable, break off and go up into the brain causing stroke. In those types of scenarios, treatment often involves surgery and we can talk about that later.
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